Pelvis and Perineum Flashcards
What is the pelvic outlet?
The inferior opening of the pelvis
What is the true pelvis formed by?
Pubis Ischium Coccyx Sacrum (PICS)
What is the false pelvis?
Lumbar vertebrae
Iliac Fossa
Abdominal wall
(LIA(R))
What type of joint is the sacroiliac joint?
Synovial plane joint
What type of joint is the pubic symphysis?
Secondary cartilaginous joint
How is the female greater pelvis described
Large and Broad
How is the male greater pelvis described?
Small and Narrow
How is the female pelvic inlet described?
Wide and Oval
How is the male pelvic inlet described?
Narrow and heart shaped
How is the female pelvic outlet described?
Wide
How is the male pelvic outlet described?
Narrow
What is the female suprapubic angle?
Obtuse
Greater than 90 degrees
What is the male suprapubic angle?
Acute
Less than 90 degress
What shape is the female obturator foramen?
Oval shaped
What shape is the male obturator foramen?
Rounded
Is the female acetabulum large or small?
Small
Is the male acetabulum large or small?
Large
What is the narrowest diameter of the pelvic inlet?
12cm
Anteroposterior
What is the narrowest diameter of pelvic outlet
11cm
Transverse
How is the female lesser pelvis described?
Flexible
Straight
How is the male lesser pelvis described?
Coccyx projects in and is immovable
What walls does the pelvic cavity have?
Antero-inferior
2 lateral walls
Posterior wall
What is the anterior-inferior formed by?
The bodies and the rami of the pubic bones
The pubic symphysis
What is the perineal body?
Central tendon of the perineum
An irregular fibromuscular mass
Where is the perineal body located?
At the junction of the urogenital and anal triangles
the central point of the perineum
What does the perineal mass act as in women?
A tear resistant body between the vagina and the external anal sphincter
Where does the perineal body lie in the male?
Between the bulb of the penis and the anus
What is the anococcygeal body?
The muscle and fibrous tissue between the coccyx and anus
What 2 muscles make up the majority of the pelvic floor?
Levator ani
Coccygeus
Which pelvic floor muscle has 3 separate paired muscles?
Levator ani
List 2 functions of the pelvic floor?
Support the abdominopelvic viscera
Resistance to increases in inta-pelvic/abdominal pressure
What is the innervation of the pelvic floor?
Pudendal nerve
What is the pudendal nerve?
S2-S4
What is cystocele?
A condition where the bladder bulges into the vagina
Weakening of the wall between the bladder and vagina
What does cystocele cause?
Frequent urination
Pain during sexual intercourse
What is rectocele?
Wall which separates the rectum from the vagina is weakened
Vaginal wall bulges
What injury to the pelvic floor during childbirth is common and potentially damaging?
Anal continence
What are the main pelvic viscera (organs) in the female?
Bladder
Bowel
Uterus
What are the main pelvic viscera (organs) in a man?
Bladder
Bowel
Branches of which arteries distribute blood to most of the pelvic organs?
Left and right internal iliac arteries
What is the function of the pelvic floor?
Separates the pelvic cavity and the perineum
Attaches the walls of the lesser pelvis
What are the gaps in the pelvic floor called?
Urogenital hiatus
Rectus hiatus
Where is the perineal body situated?
Between the rectus hiatus and the urogenital hiatus
Which venous plexus does prostatic venous plexus communicate with on the posterior side?
Internal Vertebral Venous plexus
Which somatic nerves supply the pelvis organs?
Ilioinguinal nerve
Genitofemoral nerve
Pudendal nerve
From which vertebral level does the ilioinguinal nerve originate?
L1
Where does the ilioinguinal nerve enter the inguinal canal?
At the superficial inguinal ring
What does the ilioinguinal nerve supply in the male?
The skin at the root of the penis
What does the ilioinguinal nerve supply in the female?
The skin of the labia
At which vertebral level does the genitofemoral nerve originate?
L1-L2
Where does the genitofemoral nerve enter the inguinal canal?
At the deep inguinal ring
What does the genital branch of the genitofemoral nerve supply?
Cremaster muscle
Anterior scrotal skin
What does the pudendal nerve arise from?
The sacral plexus
What does the pudendal nerve follow the course of?
The pudendal artery
What does the pudendal nerve innervate?
The skin and muscles of the perineum
Which segmental levels does the pudendal nerve arise?
S2-S4
What bony landmarks are used when performing a pudendal nerve block during labour?
Ischial spine
What does the autonomic nerve supply to the pelvis originate from?
The Pelvic Plexus
What is another term for the pelvic plexus?
Inferior hypogastric
What do the sympathetic fibres of the autonomic system originate from?
L1 and L2 via the hypogastric nerve and terminal aspect of the sympathetic trunk
What do the sympathetic fibres of the autonomic system supply?
Sympathetic supply to all the internal pelvic organs
What do the sympathetic fibres of the autonomic system supply in the male?
Vas deferens
Seminal vesicles
Prostate
Epididymis
What do the sympathetic fibres of the autonomic system supply in the female?
Ovaries
Uterus
Fallopian tubes
Vagina
Where do the parasympathetic fibres of the autonomic system originate from?
Pelvic splanchnic nerve (S2-S4)
What do the parasympathetic fibres of the autonomic system supply in the males and females?
Erectile tissue
What do the external iliac nodes drain?
Bladder Prostate Urethra Cervix Upper part of vagina
What do the internal iliac nodes drain?
Gluteal region
Deep perineum
Inferior pelvic viscera
What do the sacral lymph nodes drain?
Rectum
Posterior pelvis
What do the common iliac nodes drain?
External iliac nodes
Internal iliac nodes
Sacral lymph nodes